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Related Experiment Video

Updated: May 25, 2026

Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection
05:32

Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection

Published on: September 21, 2015

The risks of PPI therapy.

Paul Moayyedi1, Grigorios I Leontiadis

  • 1Division of Gastroenterology, Department of Medicine, McMaster University, 1280 Main Street West, HSC Room 4W8E, Hamilton, ON L8S 4K1, Canada. moayyep@mcmaster.ca

Nature Reviews. Gastroenterology & Hepatology
|February 15, 2012
PubMed
Summary
This summary is machine-generated.

Proton pump inhibitors (PPIs) are widely used for acid-related disorders but carry potential risks. Evidence suggests these risks, including pneumonia and cardiovascular events, may be overstated and not supported by randomized trials.

Related Experiment Videos

Last Updated: May 25, 2026

Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection
05:32

Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection

Published on: September 21, 2015

Area of Science:

  • Gastroenterology
  • Pharmacology
  • Clinical Medicine

Background:

  • Proton pump inhibitors (PPIs) are globally prevalent medications for acid-related gastrointestinal disorders.
  • Concerns exist regarding PPI therapy's association with pneumonia, bone fractures, enteric infections, and cardiovascular events, particularly with clopidogrel use.

Purpose of the Study:

  • To critically evaluate the evidence linking PPI therapy to potential adverse events.
  • To differentiate between associations observed in observational studies and findings from randomized controlled trials (RCTs).

Main Methods:

  • Review and synthesis of existing observational studies and randomized controlled trials concerning PPI use and associated risks.
  • Analysis of the strength of association for various adverse events, including enteric infections and cardiovascular events with clopidogrel.

Main Results:

  • Observational studies indicate modest associations between PPIs and risks like pneumonia, fractures, and infections; the link to enteric infections appears stronger.
  • Evidence from RCTs does not substantiate a clinically significant increased risk of cardiovascular events in patients on clopidogrel or an increased risk of pneumonia with PPI use.
  • Limitations of observational studies, including bias and confounding factors, may explain observed associations.

Conclusions:

  • While some associations between PPIs and adverse events are noted, RCT evidence does not consistently support these risks.
  • The possibility of causal links or unknown long-term effects cannot be entirely excluded.
  • Clinical guidelines recommend judicious PPI prescription, reserving them for patients with proven benefits.